The establishment of the Human Studies Review Board (HSRB) follows a long history of ethical concerns. While extreme examples associated with the last World War come to mind, there are numerous activities in the United States that increased pressure for further human protection. A profound lapse in ethical behavior is the Tuskegee Syphilis study. This study, sponsored by the US Public Health Service, spanned 40 years from 1932 and recruited 399 African American males from Alabama for a study of "bad blood." In fact, the purpose of the study was to follow these men as they developed late stage syphilis. While effective treatment for syphilis was not available at the beginning, penicillin became available in the 1940's. This treatment was intentionally withheld from study participants. It was only after the study was exposed on national media and public outrage ensued that the study terminated. As a direct consequence, the National Research Act of 1974 was passed increasing protections for human subjects. Institutional Review Boards were established a year later by the Department of Health, Education and Welfare. The 1979 Belmont Declaration further denned the ethical considerations governing medical studies. In 1988 the Interagency Human Subjects Coordinating Committee increased protections.
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